The importance of vitamin B12 for individuals choosing plant-based diets.

Vitamin B12 is an essential nutrient that is not made by plants; consequently, unfortified plant-based foods are not a reliable supply. Recent estimates suggest high rates of vitamin B12 deficiency among the vegetarian and vegan populations, particularly in pregnant women or women of child-bearing age who, for ethical and health reasons, are shifting towards higher consumption of plant-based foods in ever-increasing numbers. Vitamin B12 plays crucial metabolic roles across the life-course and in particular during pregnancy and in early development (first 1000 days of life). Evidence now implicates vitamin B12 deficiency with increased risk to a range of neuro, vascular, immune, and inflammatory disorders. However, the current UK recommended nutrient intake for vitamin B12 does not adequately consider the vitamin B12 deficit for those choosing a plant-based diet, including vegetarianism and in particular veganism, representing a hidden hunger. We provide a cautionary note on the importance of preventing vitamin B12 deficits for those individuals choosing a plant-based diet and the health professionals advising them.

Utilization of cervical cancer screening and its associated factors among women of child-bearing age in Mangochi district, Malawi: a facility-based cross-sectional study.

BACKGROUND: Cervical cancer screening (CCS) uptake remains low in poor countries. Few studies have assessed individual need and health system factors which facilitate/impede use of healthcare services, including CCS utilization. Thus, we examined associations between these factors and CCS utilization among women of child-bearing age (WCBA) in Mangochi, Malawi. METHODS: A cross-sectional study, sampling 482 women (18-49 years) using a multi-stage sampling method was conducted in five health facilities (HFs). Data were collected using a structured interview questionnaire from June-July, 2019. Chi-squared or Fisher's exact tests were used to compare the distribution of CCS utilization according to different independent groups. RESULTS: Our study found that 13.1% of the study participants had a history of CCS. The proportion of WCBA with a history of CCS was significantly higher among HIV + women than HIV- women and women with unknown HIV status, respectively [27.3% (33/121) vs. 8.5% (30/353) vs. 0% (0/8), χ2 = 29.18, df = 2, p < 0.001]. Significantly higher among those who had ever heard of cervical cancer (CC) than those who had not [23.0% (60/261) vs. 1.4% (3/221), χ2 = 49.28, df = 1, p < 0.001], among those who heard of CC from HFs than those who heard through radios, friends/family and other sources, respectively [31.2% (44/141) vs. 16.7% (7/42) vs. 9.3% (5/54) vs. 16.7% (4/24), χ2 = 12.62, df = 3, p = 0.006], among those with positive beliefs towards CCS than those with negative beliefs [19.2% (53/276) vs. 4.9% (10/206), χ2 = 21.37, df = 1 p < 0.001], among those recommended for CCS by health workers (HWs) than those not recommended [19.6% (53/270) vs. 4.7% (10/212), χ2 = 23.24, df = 1, p < 0.001], among those willing to be screened by male HWs than those unwilling [14.4% (60/418) vs. 4.7% (3/64), χ2 = 4.57, df = 1, p = 0.033]. Fisher's exact test showed that CCS uptake among WCBA varied significantly by level of knowledge of CC signs/symptoms, with 66.7% (12/18) and 19.8% (48/243) among those with high-level and low-level knowledge screened, respectively (p < 0.001). CONCLUSIONS: HIV status, ever heard of CC, sources of information, knowledge of CC signs/symptoms, beliefs, recommendations by HWs for CCS, willingness to be screened by male HWs were associated with CCS utilization. Thus, sensitization campaigns for CCS should be conducted to increase uptake. Further, health facilities should intensify health education on CC, including signs and symptoms to increase knowledge. In addition, CC program implementers should be willing to train both males and females to offer CCS as the clients are open to be attended to by male providers as well.

Socio-demographic determinants of cervical cancer screening uptake among women of child-bearing age in Mangochi, Malawi: a facility-based cross-sectional study.

BACKGROUND: Cervical cancer (CC) is the number one leading cause of death among women in Malawi. However, it is generally viewed as preventable and treatable if diagnosed in an early stage. Despite the burden, Malawi registers low uptake of cervical cancer screening (CCS). This study examined the socio-demographic determinants of CCS uptake among women of child-bearing age (WCBA) in Mangochi district. METHODS: A cross-sectional quantitative study was conducted in five health facilities. A total of 482 women between the ages of 18-49 participated and were sampled using a multi-stage sampling method. An interviewer administered structured questionnaire was used to collect data from June to July, 2019. Multivariate logistic regression model was used to identify determinants of CCS uptake among WCBA. RESULTS: Few respondents (13.1%) had ever done CCS. Compared to respondents in the age-group of 18-24 years, those in the age-groups of 25-35 years and 36-49 years were 2.63 and 3.90 times more likely to undergo CCS (AOR = 2.63, 95% CI 1.30-5.31 and AOR = 3.90, 95% CI 1.62-9.38), respectively. Respondents who practiced Christianity were 2.77 times more likely to undergo CCS than those who practiced Islam (AOR = 2.77, 95% CI 1.23-6.22). Respondents of the Chewa ethnic group were 71% less likely to undergo CCS as compared to those of Yao ethnicity (AOR = 0.29, 95% CI 0.09-0.95). Respondents who lived in semi-urban areas were 2.57 times more likely to go for CCS than those who were village residents (AOR = 2.57, 95% CI 1.19-5.55). CONCLUSION: Our study showed that CCS uptake was low in Mangochi and the results suggested that age, religion, ethnicity and place of residence were determinants of CCS uptake. We recommend that comprehensive health education on CC should specifically target the young women and Muslim women in places where they meet. We call upon the district health authorities to scale up CCS provision in all Antiretroviral Therapy (ART) and outreach clinics to improve CCS uptake among women residing in the villages and those of the Chewa ethnicity. We, further, call upon all CC program implementers to design programs that address the highlighted socio-demographic determinants of CCS uptake among WCBA in the district.

Livestock ownership and anaemia in Sub-Saharan African households.

OBJECTIVE: To determine the association between livestock ownership and Hb concentration of women of child-bearing age (WCBA) and preschool-aged children in Sub-Saharan Africa (SSA). DESIGN: A prospective analysis of publicly available cross-sectional data, using linear and logistic regressions controlling for potential confounders. SETTING: Twenty-eight countries in SSA. PARTICIPANTS: 162 305 WCBA and 118 607 children aged 6-59 months. RESULTS: More than half of WCBA (62·5 %) and children (58 %) belonged to households that owned livestock. The average altitude-adjusted blood Hb concentration for WCBA and children was 12.23 and 10·24 g/dL, respectively. In adjusted models, higher number of livestock owned was associated with lower Hb concentration for children but not for WCBA. The magnitude of the association for children was small, with one additional unit of livestock owned reducing Hb concentration by 0·001 g/dL. Higher numbers of cattle, cows and bulls, sheep, and goats were associated with lower Hb concentration for both groups. The number of certain categories of livestock owned was associated with the consumption of relevant foods by children. There was no association between the consumption of animal-source foods and Hb concentration or between livestock ownership and diarrhoeal diseases or fever among children. CONCLUSIONS: Livestock ownership in SSA had a net negative association with the Hb concentration of children and no association with that of WCBA. The results highlight the need for research aimed at clarifying the mechanisms linking livestock ownership and nutritional status, and identifying entry points for leveraging livestock ownership to improve the health of women and children in SSA.

Necessity for subsequent surgery in women of child-bearing age with positive margins after conization.

BACKGROUND: 20-25% of women with high-grade cervical intraepithelial neoplasias (HSIL) have residual lesions after conization. The state of the margin is generally considered to be a risk factor for recurrence or persistent lesions. Predictors of positive margins and residual lesions need to be identified. A design for postoperative management and avoidance of overtreatment needs to be provided, especially for women of child-bearing age. METHODS: This study was a retrospective analysis of 1309 women of child-bearing age with HSIL, who underwent cold knife conization (CKC). Age, gravidity, parity, human papillomavirus (HPV) species, cytology, transformation zone type, results of endocervical curettage (ECC), quadrant involvement, glandular involvement, and Cervical Intraepithelial Neoplasia (CIN) grade were analyzed. Among those with positive margins, 245 patients underwent secondary surgery within three months, including CKC, a loop electrosurgical excision procedure, and total hysterectomy. Risk factors for positive margins and residual lesions were assessed. RESULTS: There was no significant difference in age, gravidity, parity, glandular involvement, and CIN grade between the two groups (P > 0.3). There was a significant difference in HPV species, cytology, ECC results, and quadrant involvement (P < 0.002). Multivariate analysis showed a major cytology abnormality, high-risk HPV infection, type III transformation zone, positive ECC result, and multiple quadrant involvement were independent risk factors for positive margins and residual lesions (P < 0.02). Age > 35 years was also a risk factor for residual lesions (P < 0.03). CONCLUSION: High-risk women should be treated appropriately considering fertility. Patients with positive margins should be managed uniquely. Surgery for women without fertility may be appropriate. Close follow-up is necessary for women who have fertility requirements or are unwilling to undergo subsequent surgery if they have no risk factors, especially women < 35 years.

Pro-vitamin A carotenoid content of 48 plantain (Musa AAB genome) cultivars sourced from eastern Democratic Republic of Congo.

BACKGROUND: Vitamin A deficiency (VAD) is widespread in sub-Saharan Africa (SSA). Unlike in developed countries, where the main source of vitamin A comes from meat, the diet of poor populations in SSA is largely plant based. It is thus important to identify local / popular plants with higher vitamin A content for combating VAD. Banana (including plantains) is an important staple food crop in this region. The identification and promotion of vitamin A-rich banana cultivars could contribute significantly to the alleviation of VAD in areas heavily dependent on the crop. We assessed pro-vitamin A carotenoid (pVACs) content in the fruit pulp of 48 local plantains from eastern Democratic Republic of Congo, to identify cultivars that could help reduce VAD, especially among young children and women of reproductive age. RESULTS: Mean pVACs content varied from 175-1756 µg/100 gfw in ripe fruits. Significant increases (P < 0.001) in total pVACs content occurred after ripening in all cultivars except 'UCG II'. Retinol activity equivalents (RAE) in ripe fruits ranged from 12-113 µg/100 gfw. Fifteen plantain cultivars, including 'Adili II', 'Nzirabahima', 'Mayayi', 'Buembe', and 'Sanza Tatu' (associated with RAE values of 44 µg/100 gfw and above) can be considered as good sources of pVACs. Modest consumption (250 or 500 gfw) of the fruit pulp of the five best plantain cultivars at ripening stage 5 meets between 39-71% and 44-81% of vitamin A dietary reference intake (DRI) respectively, for children below 5 years old and women of reproductive age. CONCLUSION: The 15 best plantain cultivars (especially the top 5) could potentially be introduced / promoted as alternative sources of pro-vitamin A in banana-dependent communities, and help to reduce cases of VAD substantially. © 2019 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

[Serum vitamin D levels of Chinese rural women of childbearing age in 2010-2012].

OBJECTIVE: To obtain the serum 25-hydroxyvitamin D status for women of child-bearing age aged 18-44 years from rural areas in China Health and Nutrition Survey2010-2012( CHNS 2010-2012). METHODS: We randomly selected the 1520 representative women of childbearing age from the 75 monitoring spots derived in the CNHS 2010-2012. The information of study population were collected using questionnaires and the serum 25-hydroxyvitamin D concentration was determinedusing the RIA kits. The vitamin D nutritional status was classified by the standards suggested by the America Endocrine Society. Multiple Logistic regression analysis was explored therelationship between vitamin D status with the potential relevant factors. RESULTS: The median serum 25-hydroxyvitamin D concentration was 22. 7 ng/m L ranged from 8. 2 to42. 0 ng/m L. The prevalence of vitamin D deficiency was 38. 7%, insufficiently 39. 5%and sufficiently 21. 8%. Multiple Logistic regression analysis showed that nationality, geographical regions and income per capita was the significant. CONCLUSION: s The nutritional status of vitamin D in women of child bearing-age is not better in the CNHS2010-2012. We suggest that it should be pay more attention on the women of childbearing age for the minority, north China, family income per year between 10000 and 30000 Yuan.

De novo combination therapy adefovir plus lamivudine as a treatment for women of child-bearing age with HBeAg-positive chronic hepatitis B before pregnancy.

Substantial progress has been achieved in antiviral therapy for chronic hepatitis B; however, options for women of child-bearing age with HBeAg-positive chronic hepatitis B remain a challenge. In this study, we sought to determine whether de novo combination therapy of Adefovir plus Lamivudine was a super treatment for women of child-bearing age with HBeAg-positive chronic hepatitis B prior to conception. A total of 122 women patients of child-bearing age with HBeAg-positive chronic hepatitis B were randomly assigned to receive (i) 10 mg Adefovir plus 100 mg Lamivudine (64 patients) or (ii) 10 mg Adefovir monotherapy (58 patients), administrated orally once daily for 96 weeks. The therapeutic efficacy within each group was compared at weeks 48 and 96. The results showed that de novo combination therapy of Adefovir plus Lamivudine significantly reduced HBV-DNA detectability, and enhanced ALT normalization and HBeAg seroconversion in women of child-bearing age with HBeAg-positive chronic hepatitis B. No virological breakthrough and genotypic resistance were observed in the combination therapy group. Additionally, the combination therapy with Adefovir plus Lamivudine was well tolerated. This study suggests that de novo combination therapy of Adefovir plus Lamivudine offers a therapeutic advantage for women of child-bearing age with HBeAg-positive chronic hepatitis B when taken before conception.

Global, regional, and national burden of female cancers in women of child-bearing age, 1990-2021: analysis of data from the global burden of disease study 2021.

Background: The global status of women's health is underestimated, particularly the burden on women of child-bearing age (WCBA). We aim to investigate the pattern and trend of female cancers among WCBA from 1990 to 2021. Methods: We retrieved data from the Global Burden of Disease Study (GBD) 2021 on the incidence and disability-adjusted life-years (DALYs) of four major female cancers (breast, cervical, uterine, and ovarian cancer) among WCBA (15-49 years) in 204 countries and territories from 1990 to 2021. Estimated annual percentage changes (EAPC) in the age-standardised incidence and DALY rates of female cancers, by age and socio-demographic index (SDI), were calculated to quantify the temporal trends. Spearman correlation analysis was used to examine the correlation between age-standardised rates and SDI. Findings: In 2021, an estimated 1,013,475 new cases of overall female cancers were reported globally, with a significant increase in age-standardised incidence rate (EAPC 0.16%), and a decrease in age-standardised DALY rate (-0.73%) from 1990 to 2021. Annual increase trends of age-standardised incidence rate were observed in all cancers, except for that in cervical cancer. Contrary, the age-standardised DALY rate decreased in all cancers. Breast and cervical cancers were prevalent among WCBA worldwide, followed by ovarian and uterine cancers, with regional disparities in the burden of four female cancers. In addition, the age-standardised incidence rates of breast, ovarian, and uterine cancers basically showed a consistent upward trend with increasing SDI, while both the age-standardised incidence and DALY rates in cervical cancer exhibited downward trends with SDI. Age-specific rates of female cancers increased with age in 2021, with the most significant changes observed in younger age groups, except for uterine cancer. Interpretation: The rising global incidence of female cancers, coupled with regional variations in DALYs, underscores the urgent need for innovative prevention and healthcare strategies to mitigate the burden among WCBA worldwide. Funding: This study was supported by the Science Foundation for Young Scholars of Sichuan Provincial People's Hospital (NO. 2022QN44 and NO. 2022QN18); the Key R&D Projects of Sichuan Provincial Department of Science and Technology (NO. 2023YFS0196); the National Natural Science Foundation of China (No. 82303701).

A systematic literature review to examine the considerations around pregnancy in women of child-bearing age with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) or aquaporin 4 neuromyelitis optica spectrum disorder (AQP4+ NMOSD).

BACKGROUND: Aquaporin-4 antibody positive (AQP4+) neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are rare autoimmune diseases with overlapping phenotypes. Understanding their clinical manifestation prior to, during and after pregnancy may influence the management of women of child-bearing age (WOCBA) with these diseases. METHODS: This systematic review identified relevant MEDLINE-indexed publications dated between 01 January 2011 and 01 November 2021, and congress materials from key conferences between 01 January 2019 and 01 November 2021. These were manually assessed for relevance to AQP4+ NMOSD and/or MOGAD in WOCBA, with selected data extracted and considered. RESULTS: In total, 107 articles were retrieved and reviewed for relevancy, including 65 clinical studies. Limited evidence was found regarding a conclusive impact of either disease on female fertility, sexual function or menarche, and impact on maternal outcomes requires further investigation in both conditions to establish risk for pre-eclampsia, gestational diabetes and other complications relative to the general population. Collated data for pregnancy outcomes show clear risks in AQP4+ NMOSD to healthy delivery and a rise in annualised relapse rate postpartum that may require adaptation of treatment regimens. Disease activity appears to be attenuated during pregnancy in MOGAD patients with an increased risk of relapse during the postpartum months, but strong conclusions cannot be made due to a paucity of available data. CONCLUSIONS: This review brings together the literature on AQP4+ NMOSD and MOGAD in WOCBA. The potential impact of pregnancy and the postpartum period on disease activity suggest a proactive management strategy early on may improve maternal and infant outcomes, but more clinical data are needed, particularly for MOGAD.

Frequency Of Folic Acid Deficiency In Women Of Childbearing Age Presenting At Ayub Teaching Hospital Abbottabad.

BACKGROUND: Folic acid deficiency is one of the most common deficiencies among women of childbearing age. It can lead to neural tube defects, a significant cause of disability and mortality among infants. Therefore, the main objective of this study was to determine a folic acid deficiency in women of childbearing age in Ayub Teaching Institute, Abbottabad. METHODS: This cross-sectional study was carried out in Ayub Teaching Institute, Abbottabad from January to June 2020. In this study, a total of 193 women of childbearing age were included through consecutive sampling. RESULTS: In this study 193 women of childbearing age were included. Mean age was 30±4.87 years. Out of 193 patients, 56.7% were found to be anemic and 38.9%were found to have folic acid deficiency. CONCLUSIONS: Our study concludes that the majority of women of child bearing age are anemic in our set up. Moreover, the frequency of folic acid deficiency is 38.9 % which is high.

Pregnancy outcomes in a malaria-exposed Malian cohort of women of child-bearing age.

In Sub-Saharan Africa, malaria continues to be associated with adverse pregnancy outcomes including stillbirth, early neonatal death, preterm delivery, and low birth weight. Current preventive measures are insufficient and new interventions are urgently needed. However, before such interventions can be tested in pregnant women, background information on pregnancy outcomes in this target population must be collected. We conducted an observational study in Ouélessébougou, Mali, a malaria-endemic area where first antenatal visit commonly occurs during the second trimester of pregnancy, hindering calculation of miscarriage rate in the population. To accurately determine the rate of miscarriage, 799 non-pregnant women of child-bearing age were enrolled and surveyed via monthly follow up visits that included pregnancy tests. Out of 505 women that completed the study, 364 became pregnant and 358 pregnancies were analyzed: 43 (12%) resulted in miscarriage, 28 (65.1%) occurred during the first trimester of pregnancy. We also determined rates of stillbirth, neonatal death, preterm delivery, and small for gestational age. The results showed high rate of miscarriage during the first trimester and established a basis to evaluate new interventions to prevent pregnancy malaria. This survey design enabled identification of first trimester miscarriages that are often missed by studies conducted in antenatal clinics. Clinical trial registration: [https://clinicaltrials.gov/], identifier [NCT0297 4608].

Dietary Habits and Medications to Control Hypertension Among Women of Child-Bearing Age in the United States from 2001 to 2016.

BACKGROUND: Hypertension (HTN) in pregnancy is a leading cause of maternal morbidity and mortality in the United States. Although the Dietary Approaches to Stop Hypertension (DASH) diet is recommended for all adults with HTN, rates of DASH adherence and antihypertensive medication use in women of child-bearing age are unknown. Our objectives were to determine DASH adherence and antihypertensive medication use in women of child-bearing age. METHODS: In the National Health and Nutrition Examination Surveys from 2001 to 2016, we estimated DASH adherence among women of child-bearing age (20-50 years). We derived a DASH score (0-9) based on 9 nutrients, with DASH adherence defined as DASH score ≥4.5. HTN was defined by blood pressure (BP) ≥130/80 mm Hg or antihypertensive medication use. DASH scores were compared across BP categories and antihypertensive medication use was categorized. RESULTS: Of the 7,782 women, the mean age (SE) was 32.8 (0.2) years, 21.4% were non-Hispanic Black, and 20.3% had HTN. The mean DASH score was 2.11 (0.06) for women with self-reported HTN and 2.40 (0.03) for women with normal BP (P < 0.001). DASH adherence was prevalent in 6.5% of women with self-reported HTN compared with 10.1% of women with normal BP (P < 0.05). Self-reported HTN is predominantly managed with medications (84.8%), while DASH adherence has not improved in these women from 2001 to 2016. Moreover, 39.5% of US women of child-bearing age are taking medications contraindicated in pregnancy. CONCLUSIONS: Given the benefits of optimized BP during pregnancy, this study highlights the critical need to improve DASH adherence and guide prescribing among women of child-bearing age.

Exploring In Vivo Dynamics of Bovine Milk Derived Gangliosides.

Gangliosides are glycosphingolipids present in mammalian cell membranes, playing important structural and functional roles. Human studies on the health benefits of gangliosides are increasing, but knowledge gaps regarding ganglioside analysis exist. The study aimed to investigate blood sample type (serum/plasma), storage conditions, diurnal, day-to-day variation and acute effects of consuming bovine-derived gangliosides on circulating monosialylated gangliosides. Seventy-one women (18-40 yrs, 20-≤30.0 kg/m2) were enrolled and 61 completed the intervention. They visited the clinic three times following overnight fasting. Serum/plasma gangliosides were analyzed over 2 h (visit-1), 8 h (visit-2) and 8 h following either zero or high ganglioside meals (visit-3). Samples stored at -20 °C and -70 °C were analyzed at 3-, 6-, 12- and 18-months. Plasma and serum GM3-gangliosides did not differ, plasma GM3 did not change diurnally, from day-to-day, in response to a high vs. low ganglioside meal or after 7-days low ganglioside vs. habitual diet (P > 0.05). GM3 concentrations were lower in samples stored at -70 °C vs. -20 °C from 6-months onwards and decreased over time with lowest levels at 12- and 18-months stored at -70 °C. In conclusion, either serum/plasma stored at -20- or -70 °C for up to 6 months, are acceptable for GM3-ganglioside analysis. Blood samples can be collected at any time of the day and participants do not have to be in the fasted state.

Suboptimal child spacing practice and its associated factors among women of child bearing age in Serbo town, JIMMA zone, Southwest Ethiopia.

INTRODUCTION: Birth spacing is the time gaps between two consecutive life births. Optimal spacing until the next pregnancy is the resting period that allows the mother time to recover from pregnancy, and labor. Birth interval of 3 to 5 years increases maternal health and child survival and family planning programs have advocated this birth interval. OBJECTIVES: To assess prevalence of Suboptimal Child spacing practice and its associated factors among Women of Child bearing age in Serbo town, Jimma Zone Southwest Ethiopia. METHODS: Community based cross sectional study was conducted on a total of 314 women of child bearing age from March to April 2017 who were selected by simple random sampling. A semi structured questionnaire which was pretested was used to collect the data. Data was checked for completeness and analyzed using SPSS V.20. Bi-variable logistic regression and multi- variable regression were done for predictor variables associated at p-value < 0.05 with the outcome variable. RESULT: The prevalence of short birth interval in this study was 59.9%. Independent predictors like age at first marriage (AOR: 2.10, 95% CI = 1.19, 3.69), sex of index child (AOR: 1.964, 95% CI = 1.05 3.96), educational status (AOR: 3.05,95% CI = 1.68, 3.83), duration of breastfeeding (AOR: 3.09, 95% CI = 1.38, 6.96) and use of modern contraceptives (AOR: 1.94, 95% CI = 1.09, 3.45) were found to be statistically associated with short birth interval. CONCLUSION AND RECOMMENDATION: Majority of the study respondents were practicing short birth interval. Education level, age at first marriage, having female child, short duration of breastfeeding and not using of modern contraceptives were factors associated with the outcome variable. Therefore awareness about modern contraceptive utilization, importance of breastfeeding as birth spacing mechanism and impact of early marriage are recommended.

Tetanus in women of childbearing age in the infectious disease department in the national hospital of Conakry (Guinea).

OBJECTIVES: This study aimed to determine the hospital prevalence rate of tetanus in women of childbearing age in the infectious disease department of Donka CHU in Conakry and to describe their sociodemographic characteristics and outcomes. METHODOLOGY: This descriptive retrospective study examined the records of all patients aged 15 to 495 years hospitalized for tetanus over a 10-year period. RESULTS: During the study period, 74555 patients were hospitalized - 239 for tetanus. In all, 22 woman of childbearing age had tetanus, that is, 9.2%. Their mean age was 325 years. Most of the women were married (13/22) and lived in Conakry (18/22); 165 were housewives, and 65 patients had begun but not completed the required vaccinations. The incubation period was >75 days for 165 patients. Tetanus infection resulted from medical procedures for 9 women and trauma for 6. We recorded 125 deaths. The average duration of hospitalization was 215 days. CONCLUSION: Preventing tetanus requires a reinforcement of vaccination drives and especially the implementation of policies for booster reminders.

Hepatitis B knowledge among women of childbearing age in three slums in Mumbai: a cross-sectional survey.

BACKGROUND: More than 17 million people in India are chronically infected with the hepatitis B virus (HBV). Approximately one million of the 26 million children born in India annually will develop chronic HBV infection in the course of their lives. Studies have put the HBsAg prevalence rate among pregnant women in India between 0.9 % and 3.1, indicating a considerable need for public health interventions aimed at protecting their offspring from infection. The PAHAL project in Mumbai, India, conducted an HBV knowledge survey among women of childbearing age in three local slum communities preparatory to planning a comprehensive HBV education intervention targeting this population. METHODS: Female health workers approached all households in three designated slum neighborhoods: one each in the eastern suburbs (ES), western suburbs (WS) and Island City (IC). Female residents aged 18-45 were invited to participate in the study, and those who agreed to participate responded to a questionnaire that was administered in the form of an oral interview. The five sections of the questionnaire addressed demography, hepatitis B knowledge, personal risk related to hepatitis B, pregnancy and childbearing history, and the participant's most recent pregnancy. A descriptive statistical analysis was performed. RESULTS: Health workers submitted 6571 interview forms that were suitable for analysis (ES, 28 %; WS, 34 %; IC, 38 %). Large proportions of study participants were married (89 %), were not employed (94 %) and had completed less than 12 years of school (87 %). Only 240 (3.6 %) women answered yes when asked if they knew about hepatitis B. Among those women, there were high levels of accurate knowledge regarding some modes of hepatitis B transmission but low levels of accurate knowledge regarding other modes. Twenty-two percent of 739 women who had given birth within the previous 36 months reported that they had been tested for HBV during pregnancy. While 70 % of these women reported that their children had received three doses of hepatitis B vaccine, reported vaccination levels varied greatly across the three study areas. CONCLUSIONS: Despite the availability of a safe HBV vaccine, which is free for newborns and infants in many parts of India, preventing mother-to-child transmission of HBV remains a major challenge. Low awareness of HBV among women of childbearing age in Mumbai-area slums indicates a need for educational interventions targeting this population.